Systems, methods, and apparatuses for tensioning an orthopedic surgical cable used in conjunction with an orthopedic implant device, a bone, and/or bone implant or structure. At least one device in accordance with various embodiments of the invention includes a handheld body handheld body capable of receiving a portion of the orthopedic surgical cable. The handheld body includes a clamping body adapted to restrain a first portion of the orthopedic surgical cable with an adjustable gripping force, wherein a tension is placed on the orthopedic surgical cable. The handheld body also includes an adjusting mechanism adapted to cooperate with the clamping body to change the gripping force on the orthopedic surgical cable. In addition, the handheld body includes a slide adapted to change the position of the clamping body relative to the handheld body. Furthermore, the handheld body includes a force application member operably connected to the slide, wherein the slide is adapted to be manipulated in order to change the position of the clamping body in a manner whereby the tension is subject to gradual control by manipulation of the slide and force application member, and whereby the handheld body and orthopedic surgical cable are adapted to allow the orthopedic surgical cable to be tensioned by the clamping body at a first tension, and further adapted to allow the orthopedic surgical cable to be subsequently tensioned by the slide and force application member at a second tension without loss of tension.
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1. A tensioning device for an orthopedic surgical cable, wherein the orthopedic surgical cable is adapted to be installed relative to a bone in a patient, comprising:
a handheld body capable of receiving a portion of the orthopedic surgical cable, having a cable input opening and a cable output end, the handheld body comprising
a clamping body adapted to restrain a first portion of the orthopedic surgical cable with an adjustable gripping force;
wherein the clamping body is a collet that defines an opening for receiving the orthopedic surgical cable such that the opening substantially surrounds the first portion of the orthopedic surgical cable;
wherein the opening in the clamping body is adjustable such that at least a portion of the opening can be narrowed to engage the clamping body around the first portion of the orthopedic surgical cable;
an adjusting mechanism adapted to at least narrow the opening in the clamping body to engage the clamping body around the first portion of the orthopedic surgical cable;
a slide adapted to change the position of the clamping body relative to the handheld body, wherein a working length of the slide fits within the handheld body, and wherein the slide has a series of alternating notches and teeth;
a force application member operably interfacing with the slide over said working length, wherein the force application member has a protrusion adapted to engage the notches between the teeth of the slide, wherein the slide is adapted to be manipulated in order to change the position of the clamping body in a manner whereby a tension force on the orthopedic surgical cable is subject to gradual control by manipulation of the slide and force application member;
a slide return spring;
a release mechanism adapted to cooperate with the slide and to resist the force of the slide return spring in order to control and maintain the position of the slide as the force application member advances along the slide,
whereby the handheld body is adapted to allow the orthopedic surgical cable to be tensioned by the clamping body at a first tension, to be subsequently tensioned by the slide and force application member at a second tension without loss of tension while tensioning to the second tension.
2. The tensioning device of
a handle operably connected to the force application member, wherein the handle is adapted to be manipulated to actuate the force application member.
4. The tensioning device of
the force application member is adapted to advance the slide with respect to the handheld body.
5. The tensioning device of
the slide is adapted to retain a portion of the clamping body, and the slide is further adapted to permit the force application member to advance along a portion of the slide.
6. The tensioning device of
the slide comprises a ratchet, and
the force application member comprises a pawl.
7. The tensioning device of
the adjusting mechanism has a threaded portion and the slide has a threaded portion, and wherein the threaded portion of the adjusting mechanism is adapted to engage the threaded portion of the slide.
8. The tensioning device of
the release mechanism has a threaded portion and the handheld body has a threaded portion, and wherein the threaded portion of the release member is adapted to engage the threaded portion of the handheld body.
9. The tensioning device of
10. The tensioning device of
11. The tensioning device of
12. The tensioning device of
13. The tensioning device of
14. The tensioning device of
15. The tensioning device of
16. The tensioning device of
17. The tensioning device of
18. The tensioning device of
19. The tensioning device of
20. The tensioning device of
21. The tensioning device of
22. The tensioning device of
23. The tensioning device of
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This application claims priority to U.S. Provisional Ser. No. 60/612,380, entitled “Cable Tensioner,” filed on Sep. 23, 2004, which is incorporated by reference.
The invention relates generally to systems, methods, and apparatuses related to cable tensioning devices, and more specifically to systems, methods, and apparatuses for tensioning an orthopedic surgical cable used in conjunction with an orthopedic implant device, a bone, and/or bone implant or structure.
In an orthopedic surgical procedure, surgically implanted orthopedic cables are frequently used to secure bones together, or otherwise used to tie or fit other parts of the body together. An orthopedic surgical cable is typically a thin length of cable that is manufactured from a biocompatible material such as cobalt chromium alloy, or stainless steel, or another similar type of material. Generally, an orthopedic surgical cable is wrapped around an affected area of a patient's bone structure and then secured with a device such as a cable crimping device or cable clamping device in order to stabilize the bone, secure fractures, stabilize trauma, install other devices to the bone, and for other purposes. Conventional orthopedic surgical cable products and procedures can utilize a tensioning device such as a cable tensioning device to increase the tension on an orthopedic surgical cable in order to secure the orthopedic surgical cable with a sufficient or defined tension around the affected area of a patient's body. However, tensioning the cable can cause damage to the patient's body if the cable is overly tensioned. In other instances, the tension on the orthopedic surgical cable may be insufficient and the cable must be retightened or retensioned to obtain a sufficient tension. In any instance, a user may be limited in the use of his or her hands during the surgical procedure, and using a cable tensioning device may require both hands to utilize the cable tensioning device to apply and increase the tension on an orthopedic surgical cable. Therefore, tensioning the orthopedic surgical cable using conventional cable tensioning devices and procedures can be time consuming for the surgeon and increases costs due to excessive procedural time.
For example, one conventional orthopedic cable tensioning device utilizes an inline pen-type device with a cam. An initial tension can be placed on an orthopedic surgical cable by applying the cam to the cable. To secure the orthopedic surgical cable with the cam, the cam must be rotated from an unclamped position to a clamped position. When the cam is rotated to a clamped position adjacent to an orthopedic surgical cable, the cam provides a predefined amount of force on the orthopedic surgical cable. Once the cam is in a clamped position with respect to the orthopedic surgical cable, no additional force can be applied to the orthopedic surgical cable by the cam. In some instances, the predefined amount of force may not be sufficient to restrain the orthopedic surgical cable, and the cable may slip with respect to the cam. In this instance, a user may not be able to place tension on the cable.
In some instances, a conventional orthopedic cable product and an orthopedic surgical cable are used in conjunction with an orthopedic device, a patient's bone, bone implant, or other structure. For example, an orthopedic device such as a trochanteric grip, can be secured to the exterior surface of a patient's femur using one or more orthopedic cables and corresponding conventional orthopedic cable products or devices. Each time an orthopedic surgical cable is tensioned with respect to the patient's femur, the trochanteric grip becomes further secured to the exterior of the patient's femur. However, as each orthopedic surgical cable is tensioned, other previously tensioned orthopedic surgical cables may loosen, or the position of the orthopedic device may shift. In either instance, previously tensioned orthopedic cables may have to be re-tensioned or re-positioned with respect to the trochanteric grip and the patient's femur. Conventional orthopedic surgical cable products or devices used to secure the position of the orthopedic surgical cables may have to be replaced along with the orthopedic surgical cables that have become damaged or crushed due to the installation of the orthopedic surgical cable products or devices.
Systems, methods, and apparatuses according to various embodiments of the invention address some or all of the above issues and combinations thereof. They do so by providing a surgical cable tensioning device for tensioning and retensioning an orthopedic surgical cable used in conjunction with an orthopedic implant device, a bone, and/or bone implant or structure. The surgical cable tensioning device does not damage the orthopedic surgical cable when then the surgical cable tensioning device is operated or the surgical cable is tensioned or retensioned. While the surgical cable tensioning device is operated or in use, a tension can be placed and maintained on the orthopedic surgical cable without loss of tension. Furthermore, the surgical cable tensioning device can be reused along with the same surgical cable when the surgical cable tensioning device is unclamped and reclamped with respect to the surgical cable, while retensioning the surgical cable with respect to an orthopedic implant device, a bone, and/or bone implant or structure. Such systems, methods, and apparatuses are particularly useful for surgeons installing an orthopedic surgical cable within a patient's body, and attempting to tension and retension the orthopedic cable with respect to the installation of an orthopedic implant device, a bone, and/or bone implant or structure in the patient's body.
One aspect of systems, methods, and apparatuses according to various embodiments of the invention, focuses on apparatuses for tensioning an orthopedic cable for installation in a patient's body. For purposes of this document, such apparatuses are each known as a “surgical cable tensioning device.” A surgical cable clamp tensioning device permits a surgeon to save time and reduce wastage during a surgical procedure by providing the option to operate a surgical cable tensioning device clamp with one or both hands, and reuse an orthopedic surgical cable that may have been initially installed and tensioned. The surgeon may find that later during the same surgical procedure, the orthopedic surgical cable should be retensioned, and the surgical cable tensioning device permits the surgeon to retension the orthopedic cable with respect to the installation of an orthopedic implant device, a bone, and/or bone implant or structure in a patient's body.
According to another aspect of the invention, systems, methods, and apparatuses according to various embodiments of the invention include an apparatus for tensioning an orthopedic surgical cable used in conjunction with an orthopedic implant device, a bone, and/or bone implant or structure. At least one device in accordance with various embodiments of the invention includes a handheld body capable of receiving a portion of the orthopedic surgical cable. The handheld body includes a clamping body adapted to restrain a first portion of the orthopedic surgical cable with an adjustable gripping force, wherein a tension is placed on the orthopedic surgical cable. The handheld body also includes an adjusting mechanism adapted to cooperate with the clamping body to change the gripping force on the orthopedic surgical cable. In addition, the handheld body includes a slide adapted to change the position of the clamping body relative to the handheld body. Furthermore, the handheld body includes a force application member operably connected to the slide, wherein the slide is adapted to be manipulated in order to change the position of the clamping body in a manner whereby the tension is subject to gradual control by manipulation of the slide and force application member, and whereby the handheld body and orthopedic surgical cable are adapted to allow the orthopedic surgical cable to be tensioned by the clamping body at a first tension, and further adapted to allow the orthopedic surgical cable to be subsequently tensioned by the slide and force application member at a second tension without loss of tension.
According to yet another aspect of the invention, systems, methods, and apparatuses according to various embodiments of the invention can include a method for using a surgical cable tensioning device with an orthopedic surgical cable for installation of the cable with respect to a patient's body. The method includes providing an orthopedic surgical cable and a surgical cable tensioning device, the surgical cable tensioning device comprising a handheld body, a clamping body, an adjusting mechanism, a slide, and a force application member. The method also includes mounting the orthopedic surgical cable relative to a bone in a patient's body. The method also includes restraining a first portion of the orthopedic surgical cable relative to the clamping body, wherein the clamping body can apply an adjustable clamping force on a portion of the orthopedic surgical cable, wherein a tension is placed on the orthopedic surgical cable. In addition, the method includes manipulating the adjusting mechanism to increase the clamping force on the portion of the orthopedic surgical cable. Furthermore, the method includes advancing the force application member with respect to the slide to change the position of the clamping body in a manner whereby the tension is subject to gradual control by manipulation of the force application member.
According to yet another aspect of the invention, systems, methods, and apparatuses according to various embodiments of the invention can include a surgical method for using a tensioning device with an orthopedic surgical cable for installation with respect to a patient's body. The method includes providing an orthopedic surgical cable and a tensioning device, the surgical cable clamp comprising a clamping body, a clamping mechanism, and a force application member. The method also includes mounting the orthopedic surgical cable to a bone in a patient's body. In addition, the method includes connecting a first portion of the orthopedic surgical cable to the clamping body. Furthermore, the method includes gripping the first portion of the orthopedic surgical cable within a portion of the clamping body by manipulating the adjusting mechanism in a first direction so that the consequent gripping is subject to gradual control by the adjustment mechanism, thus placing a first tension in the orthopedic surgical cable. The method also includes manipulating the force application member to change the position of the slide and clamping body, wherein the tension can be gradually increased. The method includes releasing the tension in the orthopedic surgical cable by manipulating the adjustment mechanism in a second direction so that the orthopedic surgical cable can be repositioned between the clamping mechanism and the clamping body. The method also includes gripping another portion of the orthopedic surgical cable within the portion of the clamping body by manipulating the adjusting mechanism in the first direction so that the consequent gripping is subject to gradual control by the adjustment mechanism, thus placing a second tension in the orthopedic surgical cable.
Objects, features and advantages of various systems, methods, and apparatuses according to various embodiments of the invention include:
(1) providing the ability to tension an orthopedic surgical cable without damaging the cable and creating the need to replace the cable; and
(2) providing the ability to tension and retension an orthopedic surgical cable during the same surgical procedure.
Other aspects, features and advantages of various aspects and embodiments of systems, methods, and apparatuses according to the invention are apparent from the other parts of this document.
Systems, methods, and apparatuses according to various embodiments of the invention address some or all of the above issues and combinations thereof. They do so by providing a surgical cable tensioning device for tensioning and retensioning an orthopedic surgical cable used in conjunction with an orthopedic implant device, a bone, and/or bone implant or structure. The surgical cable tensioning device does not damage the orthopedic surgical cable when then the surgical cable tensioning device is operated or the surgical cable is tensioned or retensioned. While the surgical cable tensioning device is operated or in use, a tension can be placed and maintained on the orthopedic surgical cable without loss of tension. Furthermore, the surgical cable tensioning device can be reused along with the same surgical cable when the surgical cable tensioning device is unclamped and reclamped with respect to the surgical cable, while retensioning the surgical cable with respect to an orthopedic implant device, a bone, and/or bone implant or structure. Such systems, methods, and apparatuses are particularly useful for surgeons installing an orthopedic surgical cable within a patient's body, and attempting to tension and retension the orthopedic cable with respect to the installation of an orthopedic implant device, a bone, and/or bone implant or structure in the patient's body.
Typically, an orthopedic surgical cable 106 can be positioned with respect to a portion of a patient's bone 102 during a surgical procedure. One or more orthopedic surgical cables 106 can be utilized to secure any number of orthopedic devices, such as a bone plate, into a position relative to the patient's bone 102. Associated orthopedic devices, such as a cable clamp 108 can be used to secure a portion of the surgical cable with respect to the patient's bone. One end 110 of the orthopedic surgical cable 106 can be positioned through the cable tensioning device 104. When a force is applied to a cable tensioning device 104, the cable tensioning device 104 can grip a portion of the orthopedic surgical cable 108, thus restraining the orthopedic surgical cable 108 into a position relative to the patient's bone 102 and placing a tension in the cable tensioning device 104. When another force is applied to the cable tensioning device 104, the cable tensioning device 104 can gradually increase the tension in the orthopedic surgical cable 108 without loss of previously applied tension.
If necessary, the orthopedic surgical cable 108 can be loosened or otherwise retensioned by applying another force to the cable tensioning device 104 to relieve the gripping force on the orthopedic surgical cable 108 applied by the cable tensioning device 104. The orthopedic surgical cable 108 can then be retensioned by way of a cable tensioning device 104 so that the orthopedic surgical cable 108 is at a desired tension or position.
A surgical cable tensioning device in accordance with embodiments of the invention can be fashioned as a single or multiple component-type clamp. In any configuration, a surgical cable tensioning device is used to place and maintain a tension and, if necessary, change and increase the tension in an orthopedic surgical cable without loss of tension in the surgical cable. A surgical cable tensioning device in accordance with the invention can be used with other prefabricated orthopedic devices, such as a bone plate, that utilize orthopedic surgical cables for securing the device to a bone or another part of a patient's body. Finally, even though a surgical cable tensioning device in accordance with the invention is shown in
The handheld body 202 in this embodiment is a cylindrically-shaped hollow body capable of being held in a hand of a user, such as a surgeon. A cable input opening 216 adjacent to a cable input end 218 of the handheld body 202 is adapted to receive an end of an orthopedic surgical cable, such as 106 in
The clamping body 204 and slide 208 shown in
The slide 208 shown in
In the example shown in
The slide 208 shown in
Each time the handle 212 is pumped, the force application member 210 can be advanced with respect to the slide 208, and the slide 208 can be advanced towards cable output end 224 of the handheld body 202. For example, in the embodiment shown in
In the embodiment shown, a lever spring 252, such as a leaf spring, can mount to the handle 212, wherein the lever spring 252 is positioned between the handle 212 and the lateral side 250 of the handheld body 202. In addition, a body spring 254, such as a leaf spring, can mount to the lateral side 250 of the handheld body 202, wherein the body spring 254 is positioned between the handle 212 and the lateral side 250 of the handheld body 202. Either or both springs 252, 254 can provide a return force on the handle 212 when the user applies a manual force to the handle 212.
Furthermore, a slide return spring 256, such as a coil spring, can mount between the slide 208 and the cable output end 224 of the handheld body 202. For example, in the embodiment shown in
The adjusting mechanism 206 shown in
In this manner, an orthopedic surgical cable, such as 106, can initially be inserted through the handheld body 202. A leading portion of the surgical cable 106 can be inserted into the cable input opening 216 and through the corresponding channels of the slide 208, the clamping body 204, and the adjusting mechanism 206 until the leading portion of the surgical cable 106 protrudes through the cable output hole 268. When the desired position of the surgical cable 106 is attained, a user can manipulate the adjusting mechanism 206 by rotating the turning knob 260 in a first direction to apply a gradual gripping force to the portion of surgical cable 106 via the movement of the force application member 210 against the clamping body 204. As described above, the rotation of the turning knob 236 can be translated by the adjusting mechanism 206 to a lateral force upon the clamping body 204. As the lateral force increases, the gripping force of the clamping body 204 on the portion of surgical cable 106 increases. Likewise, when the turning knob 260 is rotated in an opposing, second direction the gripping force on the portion of surgical cable 106 adjacent to the clamping body 204 can be decreased. In the manner described above, the clamping body 204 can restrain the position of the orthopedic surgical cable 106 with respect to the handheld body 202, and a first tension can generated in the surgical cable 106.
When the user has sufficiently retained the position of the surgical cable 106 with respect to the handheld body 202, the user can manipulate the handle 212. Each time the handle 212 is pumped, the force application member 210 can be advanced with respect to the slide 208, and the slide 208 can be advanced towards cable output end 224 of the handheld body 202. For example, in the embodiment shown in
The release mechanism 214 shown in
The series of alternating notches and teeth 244 along the external, intermediate portion of the slide 208 can also cooperate with the pivotable release member 276 or another portion of the release mechanism 214. In one embodiment, cooperation between a slide and pivotable release member 276 or another portion of the release mechanism 214 can be akin to a combination ratchet and pawl. The pivotable release member 276 or another portion of the release mechanism 214 can include at least one protrusion 286 that can engage a corresponding notch between at least two teeth 244 along the slide 208. The pivotable release member 276 shown in
The return member 278 and spring 280 can generate a return force on the pivotable release member 276 to counter some or all of the force applied to the release knob 272. The return member 278 can mount to the lateral side 250 of the handheld body 202, and can further mount to or otherwise connect with a portion of the pivotable release member 276. In the embodiment shown in
To release a previously generated tension on a surgical cable using a cable tensioning device 200, a user such as a surgeon can hold the handheld body 202 in his or her hand, and apply a manual force via the release mechanism 214 by gripping the release knob 272 with the other hand and rotating the release knob 272 in one direction. If a user desires to maintain tension in an orthopedic surgical cable 106, the user can rotate the release knob 272 in one opposing direction to move the pivotable release member 276 towards and into contact with the slide 208. In each instance, the rotation can manipulate the position of the pivotable release member 276 towards the slide 208 or away from the slide 208. In some instances, if a user desires to release a tension in an orthopedic surgical cable, such as 106, the user can rotate the release knob 272 to move the pivotable release member 276 away from and out of contact with the slide 208.
In the embodiment shown, the functionality of the release mechanism 214 can cooperate with the functionality of the force application member 210, such that when both the force application member 210 and the release mechanism are simultaneously manipulated, the slide 208 can change position or return to an initial position and release a previously generated tension in the orthopedic surgical cable 106. In other embodiments, the functionality of a release mechanism can operate independently from the functionality of a force application member to permit the slide to change position to release a tension in the orthopedic surgical cable 106. In another embodiment, a force application member and release mechanism can cooperate to permit gradual and incremental decreases in a previously generated tension in an orthopedic surgical cable 106.
The surgical cable tensioning device 200 in
When the head channel 296 is aligned with the tip 220 and the slide 208, an orthopedic surgical cable, such as 106, can be inserted within the cable input opening 216, and pushed through the tip 220 and into the slide channel 242. In this manner, when a force is applied to the orthopedic surgical cable 106 adjacent to the cable input opening 216, the force may cause the tip 220 and head element 290 to change position relative to the handheld body 202, and move towards the cable output end 224 of the handheld body 202. This type of movement will cause the spring 292 to compress, and a return force in the spring 292 will be generated. Shown in
Various components of a surgical cable tensioning device such as 200 can be manufactured from titanium, stainless steel, cobalt chromium alloy, or another similar type of material. An example of a surgical cable tensioning device 200 measures approximately 12 inches (30.4 cm) in length parallel with the central axis of the device, approximately 1 inch (2.5 cm) in width, and approximately 2.5 inches (6.3 cm) in height from the extended tip of the handle to a lower portion of the handheld body. Furthermore, an example of a surgical cable that can be used with the surgical cable tensioning device 200 is typically a cobalt chromium or stainless steel cable measuring approximately 0.04 to 0.08 inches (1.0 to 2.0 mm) in diameter.
The surgical cable tensioning device 200 is a preferred embodiment of a surgical cable tensioning device in accordance with the invention. Other embodiments of surgical cable tensioning device can be used in the preferred environment and other similar type environments to accomplish similar functions in accordance with the invention.
In
As shown in
If, for any reason, the tension is not sufficient or desired, the user may release the tension in the cable. As shown in
More than one surgical cable may be needed to secure an orthopedic device such as a cable clamp or bone plate to a patient's bone 304. The above sequence can be repeated as needed until cable clamp, bone plate, or other orthopedic device is secured to the patient's bone. After tensioning one or more surgical cables 302 to the patient's bone with surgical cable tensioning device 300, previously tensioned surgical cables may tend to loosen or otherwise require additional tension to sufficiently secure the cable clamp, bone plate, or other orthopedic device to the patient's bone 304. If necessary, the tension on a previously tensioned surgical cable can be released by applying an untightening force to the cable clamp, bone plate, or other orthopedic device with an untightening instrument, thus releasing the compression and tension on the surgical cable 302. The surgical cable 302 can then be retensioned manually or by use of the surgical cable tensioning device 300. When the desired tension is reached using the surgical cable tensioning device 300, the position of the surgical cable 302 should be relatively stable relative to the patient's bone 304 and cable clamp, bone plate, or other orthopedic device.
Tensioning and retensioning of one or more surgical cables 302 may occur more than once during a surgical procedure until all of the surgical cables 302 are sufficiently tensioned to maintain the position of the surgical cables 302, and cable clamp, bone plate, or other orthopedic device relative to the patient's bone 304. The sequence described above with respect to
While the above description contains many specifics, these specifics should not be construed as limitations on the scope of the invention, but merely as exemplifications of the disclosed embodiments. Those skilled in the art will envision many other possible variations that within the scope of the invention as defined by the claims appended hereto.
Allen, C. Wayne, Martinez, Jaime E.
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